Part 1 Overview of the Transition
The healthcare landscape is changing dramatically. Those in the payer position are asking the health care providers to make the change from volume based care—that is to say, care that is a fee for services rendered—to value based care or a fee for the value of the services provided.
Why is the Value Based Change Necessary?
The change is said to be valuable and beneficial to everyone concerned. It benefits the client, the provider of the services as well as the payer. This change to value based payment is meant to inspire health care companies and providers to give the best possible care at the lowest possible cost. Additionally the patient or client will attain a better quality of health care and get it at a lower cost and a much better value than previously was attained.
Changing over to this methodology is one that is inherently difficult in multiple ways and is controversial at best. The measurement of value is so subjective that hospitals and acute care facilities fear they will not be given a fair shake when it comes to the payments, while patients fear that in some cases the quality of care may actually suffer.
Moving to the Value Based model will require:
Making a transformation to a network model of care.
Acquiring, aggregating and analyzing the data gathered across an entire healthcare network.
A quality integration of financial and clinical information for the patient’s view across all healthcare facilities and providers as well as over a long-time span.
A reorganization of the structure of the healthcare institutions and providers in order to permit and encourage value based payments.
Restructuring to provide for healthcare facilities to identify the means to lower their costs of operation and boost their overall efficiency.
What Other Benefits Will The Healthcare Provider See?
The typical hospital or long term care facility will see a higher number of chronic diseases that must be taken care of and the value methodology will help them to better accomplish that.
The improved access to care that is seen and the lowered network leaks will increase the patient load and help hospitals to deal more efficiently with that patient load.
The changes that are required to take us to the value based system are changes that we could and should have seen decades ago. The move to a value based system is long overdue.
These changes have the capacity to vastly improve the overall care model and the bottom line of the businesses who embrace them and provide for much better care for every patient who is a part of the system. What exactly is population health and what does it offer to the clients as well as the health care providers? Part two will offer an overview.
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